PACES MRCP UK - Where MRCPians Meet Since 2006

MRCP is well establised as an entry exam for advanced specialist training in many countries including Malaysia. It consists of 3 paper i.e. Part1, Part2(written tests) and PACES. PACES in full means Practical Assessment of Clinical Examination Skills. It is the third part and the candidate is assessed by fellows of RCP. I passed my PACES in 2005. I am glad that many seniors had guided me throughout my preparation for PACES and I wish to share my experiences with PACES candidates via this blog.

Saturday, June 23, 2007

Gait Quiz 2

Observe and describe the gait. Then, proceed with the necessary neurological examination.

Labels: Gait, Neurology, Quiz series

Saturday, June 16, 2007

Gait Quiz

The responses for quiz series so far are great! Hence, I decided to post a video demonstrating a gait disorder.

Here, it goes.

This is the neurology station. Please observe the gait.

What type of gait is this man demonstrating?

How would you proceed with the necessary neurological examination?

Video contributed by Wuchereria

Labels: Gait, Neurology, Quiz series

Monday, June 04, 2007

High Stepping Gait

High steppage gait occurs due to foot drop where dorsiflexion of the foot cannot occur. The knee is flexed and raised to allow the foot to clear the ground. It occurs in L4, 5 root lesions, common peroneal lesions, peripheral neuropathy. Occasionally it may be due to lesions in the motor cortex.

This patient has right foot drop due to a common peroneal nerve lesion.

Video contributed by Wuchereria

Labels: Gait, Neurology

Saturday, June 02, 2007

Cerebellar Gait

Instruction: Tests this patient's gait.

Presentation:
The patient has a broad-based gait. He is unable to perform tandem walking.

Proceed as follows:
Tell the examiner that you would like to examine the patient for other cerebellar signs.

Source: Wright State University

Labels: Gait, Neurology

Wednesday, May 30, 2007

Romberg's test

The 1st part of the video clip clearly demonstrates positive Romberg's test. The patient is losing his balance upon closing his eyes. Please take note that the test is considered positive only when patient is about to fall. So, please guard the patient when perfoming this test.

The 2nd part shows Stamping gait - broad based, foot stamping on the floor.

When is the lesion?
-It is seen in propioceptive disorders. The lesion is in the peripheral nerve or posterior column.

What is the lesion?
1.Peripheral neuropathy - DM,Alcoholism, Vit B12 deficiency etc
2.Tabes dorsalis
3.Subacute combined degeneration of the spinal cord (SACD)
4.Friedreich's ataxia

Labels: Gait, Neurology